In both the public and private health sectors, ensuring the satisfaction of patients’ experiences has been receiving increased focus, particularly as the National Health Insurance (NHI) in South Africa is being unveiled. Patient satisfaction is recognised as one of the most significant factors that guide a patient’s selection of a health care provider (Korda, 2012:1). In the private health sector where profitability is dependent on the admission and management of patients, measuring healthcare quality and improving patient satisfaction is crucial. This study evaluates the satisfaction of patients’ experiences in a private hospital located in Kwa-Zulu Natal. The hospital which will remain anonymous forms part of one of the largest private hospital Groups both in South Africa and abroad. Following the expansion and renovation of the facility, it now consists of 94 beds along with stateof-the-art diagnostic and treatment equipment. All patients who accessed the facility during the research period formed part of the target population. The study also had a sample size of 133. A structured questionnaire for gathering the required information was utilised as the research instrument.
This study outlines the challenges South African Education systems is exposed to and how to mend the governance which is likely to produce sustainable results through-out the country compared to neighbors like Zimbabwe which has effective educational systems in place when it comes to basic education. The dawn of democracy put education of the children in the hands of the parents so that they may able to reap the fruits of their own intentions and hard work upon the education of their children as the government in power in the country believes that people shall govern and indeed at this facet of education the parents are governing. The old system of school committees was characterized by discrimination and was highly authoritative and hierarchical as well as being undemocratically. As a result of this many schools experienced poor management, inadequate funding, ineffective teaching and poor learning.
The purpose of this study was to investigate the consequences of the increasing cases of malpractice litigation for the South African health care delivery system. Malpractice litigation has been on the rise in both state and private hospitals, throughout the country. The study was conducted in the province of Gauteng where increasing malpractice litigation has cost the Health Department millions of Rands. The study followed a quantitative research methodology approach. The data collection was conducted through a questionnaire survey; a technique which was selected because it enabled the collection of large amounts of data from many people in a short space of time. The targeted population numbered 244 and the sampling was done using a probability sampling technique (simple random sampling), which gave all the respondents an equal chance of being selected for the sample. The data analysis was carried out using the Statistical Program for Social Sciences computer program. The results were presented in frequency tables and charts. Kew Words: Impact, Medical, Litigation, Malpractice, Healthcare. Introduction The issue of medical malpractice is fast gaining momentum throughout the world and the South African health sector has not been spared. Medical malpractice is defined as the failure of a medical practitioner, hospital or hospital employee, in rendering services, to use the reasonable care, skill or knowledge ordinarily used under similar circumstances (Reed, 2009:1). According to Pepper and Slabbert (2011:29), litigation involving medical malpractice has been rising in South Africa. Medical malpractice claims have escalated, in terms of both size and frequency, and this is affecting both private and public sectors, equally. The rise in cases of medical malpractice litigation has been further increased through people being encouraged by the legal fraternity to become aware of their rights. According to Studdert, Mello and Brennan (2004:283), there are three main social goals of malpractice litigation: to deter unsafe practices, to compensate persons injured through negligence of medical , 2016 1 Vol. 2, No. 1 Journal of Research and Development (JRnD) 150 www.arabianjbmr.com practitioners, and to enable corrective justice. Choctaw (2008:13) argues that medical malpractice litigation has a negative impact on the retention of doctors, as doctors are now leaving the field of medicine, and those who remain are working in fear and silence. Child (2015:1) further stated that Health Minister Dr Aaron Motsoaledi announced an investigation into the reasons for the increase in medical litigation and negligence claims, as well as recommendations for remedial action. The rise in medical negligence lawsuits led the Health Minister to set up a team to investigate cases of medical malpractice. The minister suggested a cap on payouts to help health departments avoid bankruptcy. Subsequently, a litigation summit was held in Pretoria in March 2015 where the Minister affirmed that the country is experiencing an explosion in malpractice litigation (The Citizen 2015:1). The Aim of the Study The study aims to investigate the consequences of increasing medical malpractice litigation for health care delivery in South Africa, Gauteng. Research Objectives The objectives of the study are as follows: To identify the causes of the increase in medical malpractice litigation in South Africa; To ascertain the consequences of medical malpractice litigation for stake holders; and To offer and provide recommendations to the state and professional bodies regarding mitigating the causes of medical malpractice in South Africa’s health delivery system. LITERATURE REVIEW The issue of increasing medical malpractice is becoming grim in South Africa. Government health institutions, as well as private institutions, are increasingly being confronted with litigation related to medical malpractice. Pepper and Slabbert (2011:95) have reported that South Africa has been gradually gaining prominence in matters relating to medical malpractice. The problem of medical malpractice has resulted in medical insurance premiums rising rapidly and doctors are now more wary of being sued by patients than in the years before. There have been numerous incidences which have indicated the seriousness of medical malpractice in South Africa. The Medical Law website (2015:1) reported that according to a well-known medical journal in 2011, the percentage of reported negligence claims rose by over 130 % in South Africa over a period of two years. This rise was attributed to the increased awareness of patient rights across the world. The downside of the rise in medical malpractice in South Africa has been the rise in medical costs. Medical Malpractice Explained Medical malpractice, also known as medical negligence, has been defined by the American Medical Association as a doctor’s failure to exercise the degree of care and skill that a physician or surgeon of the same medical specialty would use under similar circumstances (Brenner, 2010:9). Oginski (2012:87) defined medical negligence as the departure from good or accepted medical care. Medical negligence has also been defined as the lack of reasonable degree of care and skill or willful negligence exhibited on the part of Medical Practitioner while , 2016 1 Vol. 2, No. 1 Journal of Research and Development (JRnD) 151 www.arabianjbmr.com treating a patient, resulting in bodily injury, ill health or death (Bardale, 2011:33). Medical malpractice includes other forms of irregular medical practice that medical health professionals might engage in, which is not fair or constitutes wrong practice. Negligence is described as a state of mind, amounting to carelessness that leads to failure to meet the set standards (Erasmus, 2008:5). Statsky (2012:124) defines negligence as the failure to use reasonable care that an ordinary person would have used in a similar circumstance, and which results in harm or some other kind of loss. The researcher defines negligence as the failure to take the reasonable precautions that a reasonable person in the position of the health professional would take when in conducting work as a health professional. The definition by Erasmus (2008:5) brings in two key elements with regard to negligence: carelessness and failure to achieve agreed standards. According to Oginski (2012:87), medical negligence can cause significant and permanent injuries to the victims. Society protects the rights of those who have been negligently injured in botched operations, or simply through the negligence of health professionals in the hospitals and clinics. Doctors are required to prepare for such eventualities by paying for medical insurance. In the United States, doctors are required to take out annual malpractice insurance, which usually costs over R1,54 million, while foreign doctors operating from the US are expected to pay insurance equivalent to R46,000 (Connell, 2011:121). Due to the rising levels of medical malpractice litigation, health professionals are urged to understand the factors which lead to possible civil claims for negligence, and to considerably more serious charges of criminal negligence. Both categories can arise from a failure to uphold required and suitable standards of care (Bryden & Storey, 2011:124). Medical Malpractice in South Africa The global rise in medical malpractice litigation has reached South Africa, a developing African country, which is now facing a serious rise in the numbers and frequency of legal battles related to medical negligence. According to Pepper and Slabbert (2011:29), until recent years, South Africa appeared to have been spared the scourge of rapidly escalating global trend towards increasing medical malpractice litigation. The country has since experienced a 132 % spike in clinical negligence claims, with the five highest claims being reported between 2006 and 2010 (Bateman, 2011:216). According to Bateman (2011:216), the most expensive medical negligence claim to be paid on behalf of a South African doctor was R17 million, paid to a patient who suffered catastrophic neurological damage in 2010. The largest claims have emanated from obstetrics, gynecology and orthopedic surgery (Pepper & Slabbert, 2011:29). The increases in malpractice settlements in South Africa have included compensation being made to young children who have been harmed through negligent treatment, specifically the substantial costs of funding lifetime care packages (Bateman, 2011:216). According to Dr Graham Howarth, MPS Head of Medical Services for Africa, obstetricians, spinal surgeons and pediatricians who perform neonatal work bear the greatest chance of facing the most expensive negligence claims (Bateman, 2011:217). According to Malherbe (2013:83), the cost of reported claims more than doubled between 2011 and 2012. The author states that claims exceeding R1 million have increased by nearly 550 %, compared with those of 10 years ago, while claims which are valued over R5 million rose by 700 % in the past 5 years. This trend in medical malpractice litigation in South Africa is , 2016 1 Vol. 2, No. 1 Journal of Research and Development (JRnD) 152 www.arabianjbmr.com approaching that of the developed world, and this is an indication that the problem is expanding with recent times. Other countries that have experienced notable malpractice suits include Taiwan, where the largest settlement was between $100 000 (R1 151 million) and $200 000 (R2, 3 million), and Kenya where one case reached $500 000 (R5.75 million) (Uejima, 2011:24). The results of the increase in medical malpractice litigation have seen a move away from compassion-Centred health care towards ‘defensive medicine’, and have also revealed the devastating emotional effects of lawsuits on health professionals (Moore & Slabbert, 2013:60). Medical practitioners are now being more careful as they attend to patients and they are more fearful of facin
Foreign aid is a concept that has taken centre stage since the past decades in world affairs. There have also been arguments whether or not foreign aids serve a useful purpose in poverty reduction/eradication in the developing nations. However, this paper believed that such facility should be utilized by the developing countries to improve upon the lives of their citizens. This paper, therefore, discusses the impact of foreign aid on poverty reduction, and or eradication programmes in Lagos State, Nigeria. It examined literature on foreign aids and poverty as well as the nature of foreign aid and its strategy for poverty reduction in Lagos State. It also investigated and analysed, how foreign aid has impacted poverty eradication/ reduction programmes in Lagos State. The methodology for the study is exploratory that made use of both primary and secondary sources of data collection. The primary sources of data were collected through interview and government document; while the secondary data were collected from textbooks, library search, scholarly peer-reviewed journal articles and internet. The data collected were content analysed. The paper found out that there are serious challenges militating against the effective use of foreign aid on poverty alleviation programmes, amongst which are; misappropriation of funds, and lack of statistics on who should benefit from the programme. The paper recommended that the government should strengthen the institutional framework to ensure adequate monitoring and deployment of training centres to accommodate more people who are willing, to effectively monitor the sessions, among others.
Nigeria is a country with a great potential in terms of human and natural resources but the ability to convert the potentials into meaningful socio-economic development is perceived to be grossly deficient. The shift in paradigms from the top-down approaches that emerged in the 1950s and 60s, to the participatory/bottom-up approaches of the 1980s and 1990s, has created more curiosity among scholars concerning the ability of the media to influence development. This challenge motivated the study to evaluate audience perception of media programmes by examining audience perception and participation as well as the impact in the attainment of national development. The development media theory provided a theoretical background for this study while the survey research method was adopted in the collection of quantitative data. Abuja and Lagos were purposively selected because of the concentration of mass media and composition of rural and urban population. A sample size of 1500 respondents was chosen using the random sampling technique. Data were obtained from primary and secondary sources. Data were analysed using a combination of frequency count and simple percentage. Results revealed that 71.4% had access to development programmes through radio and television, while 36% preferred radio as the medium for access. Radio remained a popular medium for disseminating development messages in Nigeria. In addition, majority of the respondents indicated that media programmes encourage participation in national development. It concluded that the media have been effective in supporting the national objectives. It is recommended that radio be more effectively used in disseminating messages that will impact positively on national development.
The traditional rulers is the paramount authority or natural ruler in any given community. They provide a system of administration from which law and order came and provided a stably system of governance. The objective of this paper is to examine the role of traditional institutions in modern day administration. The paper which is theoretical in nature basically, draws its arguments from secondary data including textbooks, journals, articles and publications. The paper reveals that the current 1999constitution, however did not mention the traditional institution at all thereby reversing most of the gains the institution made over the years, traditional rulers possess accurate local knowledge going back many years and may also have good networks of communication with the grassroots through title holders, traditional ruler were accorded with responsibility during colonial rule, they were members of colonial administration apparatus they were given wide power over matters in their domain. The paper concludes that, traditional rulers play a very significant role of informally managing conflict and peace making meetings when matters get out of hand, they also serves as advisory role to the local council. The paper recommends that for effective political transformation to be achieved the need to involve traditional ruler which should courts with some responsibility to 1999 constitution they serves as bridge between the government and the people, advisory role to government in administration at both national and sub-national levels and to serves the role in conflict management.
One of the current challenges facing the National Department of Health of South Africa is the shortage of skilled healthcare professionals. Trained South African health professionals have been migrating abroad, largely due to push and pull factors. In response to this, the South African National Department of Health began to explore other available mechanisms of increasing the quantity of skilled healthcare providers. In 2004, a national task team was assembled to establish a training curriculum, identify a scope of practice and outcomes for a new healthcare provider. This new cadre of mid-level providers is known as Clinical Associates. Clinical Associates perform an important part of the medical team and work under the supervision of medical doctors. They undergo three years university training and work in district hospitals throughout South Africa upon completion. Clinical Associates are similar to physician assistants in the United States of America (USA) and non-physician clinicians in the United Kingdom (UK). Similar use has been identified in other African countries such as Kenya, Tanzania and Uganda. They perform many of the tasks previously performed by physicians, including examination, diagnosis, carry out investigations, and treat patients. A full evaluation of the impact of Clinical Associates has not yet been conducted and challenges have already been identified. In this study, both qualitative and quantitative research methodologies were used. The target population comprised of Clinical Associates, medical doctors, allied healthcare professionals and members of senior management. The measuring instrument used was multiple questionnaires, assessing the effectiveness of Clinical Associates in addressing the skills shortage of healthcare professionals at Tshwane District Hospital. The instrument focused on team capacity, efficiency, flexibility, the role and scope of practice of Clinical Associates.
The civil service is the engine room of modern government. It comprises an assemblage of career officials, recruited in a civil capacity to serve the citizenry. By their training, they are equipped to champion the course of development by faithfully implementation and evaluation of government polices and programmes. They are expected to do this in a transparent and accountable manner. However, the British bequeathed civil service model in Nigeria has failed to meet the expectations of the people judging by the catalogue of dysfunctionalities in the polity. With the use of the elite model, the study submitted that the failure of the ruling elite to adhere to constitutive rules is at the heart of the present crisis plaguing the public sector. To come out of this contraption, the administrative and political elites should embrace the principles of good governance that includes: respect for institutionalism, public accountability, popular participation, equity, among others. Unless these steps are followed, the Nigerian civil service may remain a mere geographical expression with little or no growth and development.
Within the framework of labour productivity theory, the paper examined the interface between youth unemployment and labour productivity i as they relate to growth of Nigerian economy. The paper employed both qualitative and quantitative research methods to examine the incidence of youth unemployment as a function of labour productivity, agricultural, manufacturing and services contributions to real Gross Domestic Product (GDP), as well as population and inflation rate in which the growth rate of the variables were modeled. It concludes that youth unemployment, agricultural and services contributions to real GDP. It also revealed that there is have positive relationship between youth unemployment and labour productivity in Nigeria. It recommend among others, that since more employment means more income for the poor, which in turn implies a greater demand for basic locally produced goods and services. It is important for government to ensure growth and development of the rural and small-scale urban sectors. This should consider, very seriously, encouraging people to establish more labour-intensive small scale enterprises which have the propensity to create more jobs and higher incomes. This programme, if well implemented, could reverse the rural urban drift which has seriously affected the urban employment. However, in order to achieve this goal, a complementary policy of removing factor-price distortions and promoting labour-intensive technologies of production may be required
